LA LAKERS NPI 1578228375

NPI Information

NPI: 1578228375
Provider Name: LA LAKERS
Classification: Clinic/Center - 261QP2300X
Specialization: Primary Care
Entity Type: Organization
Address: 2101 NE 2ND ST APT 114
GAINESVILLE, FL
ZIP 32609
Phone: (352) 792-8069

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NPI Details

LA LAKERS is a primary care clinic center in Gainesville, FL. LA LAKERS NPI is 1578228375. The provider is registered as an organization entity type.

The provider's business location address is:

2101 NE 2ND ST APT 114
GAINESVILLE, FL
ZIP 32609-626
Phone: (352) 792-8069

The provider's authorized official is Raven Mayes .
The authorized official title is Osteopathic Medicine Physician and has the following contact phone number (352) 792-8069.

The enumeration date for this NPI number is 11/5/2021 and was last updated on 11/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	174200000X	Meals		No
2	251E00000X	Home Health		No
3	251J00000X	Nursing Care		No
4	251S00000X	Community/Behavioral Health		No
5	261QA0005X	Clinic/Center	Ambulatory Family Planning Facility	No
6	261QE0002X	Clinic/Center	Emergency Care	No
7	332100000X	Department of Veterans Affairs (VA) Pharmacy		No
8	333600000X	Pharmacy		No
9	385H00000X	Respite Care		No
10	261QP2300X	Clinic/Center	Primary Care	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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